This thesis explores the origins of occupational therapy in South Africa and how its birth, at the end of the Second World War, in a post-colonial era, with an emerging apartheid government, gave rise to an epistemology that was flawed from the start. It was flawed by virtue of its origins within a Eurocentric, paternalistic and male dominated health milieu which itself was strongly under the influence of the reductionistic and prescriptive medical model. It was flawed by virtue of the unnatural and oppressive nature of the country’s governance at the time in which everything, including health care, was designed primarily to benefit those of European descent and disadvantage those of any form of brown skin descent. It was flawed in that it did not collaborate in the design of curricula and research with the very people it served, namely, people with disabilities and black South Africans. Using historical and other relevant documentation, own life experiences, focus groups and the narratives of people with disabilities as data, this thesis attempts to expose the flawed layers described above and exactly how this impacted upon the epistemology of occupational therapy in South Africa. It also explores the changing face of occupational therapy globally and locally as a changing interface between what was then, what is becoming and what has to become in the future. The thesis ends with a flexible model that has multi-dimensional properties that provide multi-dimensional possibilities both in portraying the historical influences upon professional development and in plotting identity and curricula changes. It suggests some inherent principles essential for restructuring the occupational therapy identity and curriculum to meet this identity. It draws sustenance from the resilience that the developing South African occupational therapy profession has displayed, despite all these odds, and attempts to reconcile the errors of the past with the fast-changing face of modern day occupational therapy as it relates to professional practice, theory, contexts, policy and research in South Africa today.